About this trial
The goal of this prospective cohort study is to investigate the vestibular function in children with unilateral or bilateral sensorineural hearing loss. The main hypothesis of the study is that abnormal vestibular test results will be found in 20-30 % of the children with sensorineural hearing loss. The participants will be children in the age of 3-10 years with sensorineural hearing loss. The test protocol consists of questionnaires and vestibular and postural assessments.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Children in the age of 3-10 years
Uni- or bilateral sensorineural hearing loss > 20 dB bone conduction pure tone average measured at frequencies 0.5, 1, 2, 4 kHz
Written informed consent from the parents.
Disqualifiers
Previous inner ear surgery
Visual impairment to such a degree that the child is not able to maintain fixation on a dot one meter away.
Congenital nystagmus
Compromised eye muscle mobility
Trial population
A prospective, unselected group of children in the age of 3-10 years with either unilateral or bilateral sensorineural hearing loss is recruited at The Audiologic Clinic at Viborg Regional Hospital, Denmark. We intend to include all consecutive children fitting the inclusion and exclusion criteria.
Trial design
Cohort
Prospective
Treatments tested in this trial
video Head Impulse Test
Diagnostic testFor v-HIT, the Synapsys v-HIT Ulmer device is used.
Cervical Vestibular Evoked Myogenic Potential
Diagnostic testFor cVEMP, the Eclipse (Interacoustic, Middelfart, Denmark) is used. To bypass the frequent middle ear problems bone conduction stimuli (B-81, Interacoustic, Middelfart, Denmark) are administrated. The bone conductor is placed on the mastoid process and two trials at 70 dB nHL are conducted to check waveform reproducibility. 500 Hz short tone bursts (2-2-2 ms) are applied at 5 per second stimulus repetition rate.
Ocular Vestibular Evoked Myogenic Potential
Diagnostic testFor oVEMP, the Eclipse (Interacoustic, Middelfart, Denmark) is used. To bypass the frequent middle ear problems bone conduction stimuli (B-81, Interacoustic, Middelfart, Denmark) are administrated. The bone conductor is placed on the mastoid process and two trials at 70 dB nHL are conducted to check waveform reproducibility. 500 Hz short tone bursts (2-2-2 ms) are applied at 5 per second stimulus repetition rate.
Computerized Dynamic Posturography
Diagnostic testTo evaluate functional balance of the children and the relative contributions of the vision, proprioception, and vestibular system a CDP from Virtualis (Virtualis, Montpellier, France) is used.
Dizziness Handicap Inventory for patient caregivers
Other interventionDHI is a caregiver-reported 21- item questionnaire. It is designed to evaluate the perceived quality of life and handicap resulting from dizziness and unsteadiness for the pediatric population. For each question there are three possible answers: yes, sometimes or no. Each answer provides respectively 4, 2 and 0 points. The total DHI scores range from 0 to 84 with higher score being consistent with more limitation and more severe handicap. Scores under 16 are characterized as no limitation or handicap. A score from 16-26 present a mild perceived handicap and mild limitations. A DHI-score between 26-43 is classified as a moderate problem, and a score above 43 describes a severe perceived handicap and severe limitations.
Treatment groups
Trial outcomes
Primary outcomes
video Head Impulse Test (vHIT)
Outcome measures: mean VOR gain
video Head Impulse Test (vHIT)
Outcome measures: VOR gain asymmetry in percent (%)
video Head Impulse Test (vHIT)
Outcome measures: description of saccades (overt and covert saccades)
Cervical Vestibular Evoked Myogenic Potential (cVEMP):
Outcome measures: latency P1 and latency N1 in milliseconds (ms)
Secondary outcomes
Vestibular dysfunction
Prevalence of vestibular dysfunction
Dizziness Handicap Inventory for patient caregivers (DHI-PC):
Outcome measures: Mean total DHI-PC score. DHI-PC is a caregiver-reported 21-item questionnaire. For each question there are three possible answers: yes, sometimes or no. Each answer provides respectively 4, 2 and 0 points. The total DHI scores range from 0 to 84 with higher score being consistent with more limitation and more severe handicap.
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